Dorothea Orem

“Self- Care Deficit Model”

Person

 inidivdual with physical and emotional requirements for development of self-care and
maintenance of their well-being.
 human can reflect upon events themselves and their environment.
 They can symbolize experiences that they have been through by using words and ideas.
 Human functioning is an integrated system – physical, psychological, interpersonal and social
aspects

Health

 a state of physical, mental and social well-being and not merely the absence of disease of
infirmity (WHO).
 structural and functional wholeness of an individual.
 It is based on preventive healthcare which includes:

1. Promotion and maintenance of health

2. Treatment of disease or injury

3. Prevention of complications

Environment

 Client’s sorrounding which may affect their ability to perform their self-care activities.

Nursing

 helping clients to establish or identify ways to perform self-care activities. Nursing actions are
geared towards the independence of the client.
 it is a human service, since its focus is on persons with inabilities to maintain continuous
provision of healthcare. It is also based on values
Self-care deficit nursing theory

 it adddresses client’s self-care needs. It is a goaloriented activities that are set towards
generating interest in the part of the client to maintain life and health development. It aims
towards making client perform self-care activities in order to live independently

Major Concepts

The model is a constellation of three interrelated theories:

1. Theory of Self Care

 individuals can take responsibility for their heath and the health of others.
 individualshave the capacity to care for themselves or their dependents. Based on the
philosophy “patients wish to care for themselves.

a) Self-care.

 Practice of activities that individuals initiate and perform independently on their behalf in
maintaining life, health and well-being.

b) Self-care Agency.

 Is a human ability which is the “ability for engaging in self-care activities”- conditioned by age,
developmental state, life experience, sociocultural orientation, health and available resources.

c) Therapeutic Self-Care Demand.

 “Totality of self-care actions to be performed for some duration in order to meet self-care
requisites by using valid methods and related sets of operations and actions.”

d) Self-Care Requisites.

 Actions directed towards provision of self-care. There are three (3) categories: (a) universal, (b)
developmental and (c) health deviation

Self Care Requisites

Universal Self-Care Requisites

 needs all people have which are essential to health and vitality. It includes: air, water, food,
elimination, activity and rest, solitude and social interactions, prevention of harm and
promotion of normality.

2. Developmental Self-Care Requisites

  needs that relate to the development of the individual. These include the interventions and
teachings designed to return a person to or sustain a level of optimal health and well-being.
Examples: toilet training a child or learning healthy eating.

3. Health Deviation Requisites

 needs that arise as a result of a patient’s condition. It encompasses the variations in selfcare
which may occur as a result of disability, illness or injury.

Theory of Self-care Deficit

 the individual is unable to meet his own self care requisites.

 Professional nurse has the duty and obligation to recognize and identify such deficits in order to
define a
 support modality or intervention.Nurses are to rate their patient’s dependencies or each of the
selfcare deficits on the following scale: (a) total compensation, (b) partial compensation and (c)
educative/supportive.

Orem Five methods of helping:

1. acting for doing for others

2. guiding others

3. supporting another

4. providing an environment to promote patient’s ability

5. teaching another.

Agent.

 The individual who is engaged in meeting the needs of a person. They are like bridges that
facilitates what has been done and what needs to be done.

Dependent Care Agent.

 Individuals who takes full responsibility of taking care of a person who is incapable of providing
care for themselves or those who are living dependently with others aid

Three modalities:

1. Wholly compensatory system

 client unable to do for themselves. Total nurse care.

2. Partially compensatory system

 involves bth the nurse and the patient sharing in the self care requirements.

3. Supportive- educative system

 client has primary responsibility for personal health.

Nursing Systems:

1. Nurse’s Roles

 advocate, redirector, support person and teacher and provide an environment conducive to
therapeutic development.

2. Nursing Agency

 A set of established capabilities of a nurse who can legitimately perform activities of care for a
client. It helps a person achieve their health care demand.

3. Nursing Design.

 Are professional functions that must be performed by the nurse in order to meet clients need. It
serves as a guideline of needed and foreseen results.